Posted on May 10, 2013, 6 a.m.
An at-home exercise program for people with Alzheimer's disease helps them cope with activities of daily living, without increasing health and social care costs.
Alzheimer’s Disease is characterized by a progressive loss in functional independence, such as moving about to complete everyday tasks and handle one’s personal care. Kaisu Pitkälä, from the University of Helsinki (Finland), and colleagues enrolled 210 people with Alzheimer's disease (ages 65 years and older), who could walk independently and were living at home under the care of a spouse. Participants also satisfied one of the following conditions: at least one fall during the past year; decreased walking speed; unintentional weight loss. Subjects were randomly assigned to one of three groups for a year of study: group sessions twice weekly with about an hour of exercise, tailored home-based exercise for an hour twice a week, and a control group getting usual community care. The researchers used standardized measurements to assess physical functioning and mobility, and tracked usage of health and social services via government registers and medical records. After a year, all patients had deteriorating physical function, but those in the exercise programs had slower declines: the decline on the functional independence measure after a year was 7.1 points for those in the home exercise group, 10.3 points for those taking group exercise, and 14.4 points for those in the control group. There was no significant effect on changes in mobility. On average, the yearly cost for health and social services in the control group was $34,121 compared with $22,066 for those taking group exercise and $25,112 for those in the home exercise cohort. The study authors conclude that: “An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with [Alzheimer’s Disease] without increasing the total costs of health and social services or causing any significant adverse effects.”
Kaisu H. Pitkala, Minna M. Poysti, Marja-Liisa Laakkonen, Reijo S. Tilvis, Niina Savikko, et al. “Effects of the Finnish Alzheimer Disease Exercise Trial (FINALEX): A Randomized Controlled Trial.” JAMA Intern Med. 2013;():1-8, April 15, 2013.